title: How well do we recognise non-motor symptoms in a British Parkinson's disease population?
abstract: Although awareness of non-motor symptoms in Parkinson's disease (PD) has recently increased, little is known about their recognition and treatment in routine clinical practice. We therefore applied non-motor rating scales for dementia, depression, anxiety and excessive daytime sleepiness to a community-ascertained cohort of 202 PD patients. Hospital case notes were reviewed for evidence that the non-motor problems had been recognized and whether any action had been taken to ameliorate or assess these symptoms. The prevalence of each non-motor problem was as follows: dementia 25.3% (95% CI 19.0, 32.4), depression 37.3% (95% CI 30.6, 44.4), anxiety 31.3% (95% CI 25.0, 38.2), excessive daytime sleepiness 59.4% (95% CI 52.2, 66.3). However, these features were only recognised in 27.2, 38.7, 9.5, and 12.8%, respectively. We did not identify any specific factor that predicted under-recognition. Our study shows that when rating scales are applied to formally assess for non-motor symptoms a large clinical 'iceberg effect' emerges with the majority of symptoms going unrecognised and untreated.
authors.affiliation: Department of Neurology, Milton Keynes Hospital NHS Foundation Trust and Oxford Radcliffe Hospitals, Oxford, UK. michele.hu@clneuro.ox.ac.uk
authors.forename: Michele
authors.initials: M
authors.lastname: Hu
authors.forename: Jonathan
authors.initials: J
authors.lastname: Cooper
authors.forename: Rebecca
authors.initials: R
authors.lastname: Beamish
authors.forename: Emma
authors.initials: E
authors.lastname: Jones
authors.forename: Richard
authors.initials: R
authors.lastname: Butterworth
authors.forename: Lesley
authors.initials: L
authors.lastname: Catterall
authors.forename: Yoav
authors.initials: Y
authors.lastname: Ben-Shlomo
mesh_terms: D000368:Aged; D001007:Anxiety / Q000453:epidemiology* / Q000209:etiology; D002648:Child; D003704:Dementia / Q000453:epidemiology* / Q000209:etiology; D003863:Depression / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D007223:Infant; D008875:Middle Aged; D009483:Neuropsychological Tests; D010300:Parkinson Disease / Q000150:complications* / Q000175:diagnosis / Q000523:psychology; D015995:Prevalence; D012893:Sleep Wake Disorders / Q000453:epidemiology* / Q000209:etiology; D006113:United Kingdom